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Postoperative Nausea and Vomiting Guidelines Updated

Anesthesiologist-led expert panel revises 2003 guidelines after reviewing 250 studies

TUESDAY, Oct. 24 (HealthDay News) -- New postoperative nausea and vomiting guidelines for children and adults offer physicians up-to-date ways of preventing and treating the problem, researchers announced during the recent annual scientific meeting of the American Society of Anesthesiologists in Chicago.

Tong J. Gan, M.D., of Duke University Medical Center in Durham, N.C., and an international expert panel reviewed more than 250 studies on postoperative nausea and vomiting from February 2002 through November 2005.

The researchers found that being female, not smoking, and prior motion sickness or prior postoperative vomiting was associated with postoperative vomiting, as were general anesthesia using nitrous oxide, volatile anesthetics, postsurgical opioid use and length of surgery.

The updated guidelines note that dexamethasone, 5-HT3 receptor antagonists and droperidol cut the postoperative nausea and vomiting risk by 25 percent.

"The revised postoperative nausea and vomiting guidelines offer new information on the risk factors, prevention, and treatment of postoperative nausea and vomiting," the authors write.

Gan and colleagues conducted a related study review on postoperative vomiting in pediatric patients. The updated guidelines note that surgery lasting 30 minutes or more as well as other factors increase postoperative vomiting risk. The risk increases from 10 percent for one risk factor to 70 percent in patients with four risk factors.

Abstract (A566)
Abstract (A971)

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